Research Project 3: ICCS DIRECTED PHYSICAL ACTIVITY ENHANCEMENT FOR COLON CANCER SURVIVORS Project Summary: In the U.S., colon cancer survivors are the third largest group of cancer survivors (only breast and prostate cancer survivors surpass them). Strong evidence indicates that a sedentary lifestyle contributes not only to the incidence of colon cancer but also an increased risk of recurrence and mortality after diagnosis. To date, physical activity programs for cancer survivors have been delivered via face-to-face or telephone counseling, interventions which are costly and have limited reach. Interactive cancer communication systems (ICCS) can deliver more precisely tailored physical activity interventions to broader populations of survivors. This approach may be more effective than other delivery methods because of the dynamic interaction with the user and its' ability to continuously adapt the programs and services offered based on users' needs in real time. We propose to develop and test a new ICCS, Mobile Comprehensive Health Enhancement Support System (mCHESS) in a randomized controlled trial at three National Cancer Institute-designated cancer centers (University of Wisconsin, University of North Carolina at Chapel Hill, and MD Anderson Cancer Center) for men and women with stage l-lll colon cancer. mCHESS will provide information, tools, and a support system based on our previous work with FRESH START and CHESS, two highly successful interventions that have promoted lifestyle change among cancer survivors. mCHESS will be designed to help survivors develop 1) competence in information gathering, decision-making, and behaviors they are trying to change, 2) social support systems to help deal with the cancer experience, and 3) autonomy that comes with regaining a sense of control over their lives; this in turn, will help them adopt or maintain healthy lifestyle behaviors and improve their quality of life. We anticipate that several factors may moderate the effects of mCHESS including age, gender, education, and income as well as stage of cancer, cancer treatment, and co-morbidity. We hypothesize that autonomy, competence, and relatedness will mediate the effects that mCHESS has on physical activity (primary outcome) leading to weight change, decreased levels of distress, and increased overall quality of life (secondary outcomes), and that mCHESS use will mediate these constructs. If effective, these changes may decrease survivors' risk for recurrence and co-morbid illnesses leading to decreased morbidity and mortality from colon cancer. Data that emanate from this trial will be instrumental in guiding future interventions that bank on this emerging technology. Relevance: The survivorship project addresses both reach and efficacy components of the RE-AIM model. Extended reach is accomplished with the use of mobile technology and by addressing low literacy issues in its' design and delivery. We will test the efficacy of our program of information and support to help newly diagnosed colon cancer survivors increase their physical activity, decrease distress, and improve quality of life.